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Published in:

01-09-2010

Clinical Outcomes of Video-Assisted Skin-Sparing Partial Mastectomy for Breast Cancer and Immediate Reconstruction with Latissimus Dorsi Muscle Flap as Breast-Conserving Therapy

Authors: Hiroo Nakajima, Ikuya Fujiwara, Naruhiko Mizuta, Koichi Sakaguchi, Mahiro Ohashi, Asako Nishiyama, Yoshimi Umeda, Miho Ichida, Junji Magae

Published in: World Journal of Surgery | Issue 9/2010

Abstract

Background

Skin-sparing partial mastectomy (SSPM) has yet to be investigated as a breast-conserving therapy for early-stage breast cancer. We report the clinical outcomes for video-assisted SSPM (VA-SSPM) with immediate breast reconstruction using autogenous tissue.

Methods

VA-SSPM is indicated for early-stage breast cancer arising in the upper-outer or lower-outer quadrant without skin involvement. An incision is placed along the midaxillary line, and SSPM is performed under endoscopic guidance using subcutaneous tunneling and lifting methods. Through the same incision, a latissimus dorsi muscle flap is harvested for breast reconstruction. From January 2000 to October 2007, 168 patients (Tis, n = 24; T1, n = 37; T2, n = 107) underwent VA-SSPM, and morbidity, curability, and postoperative patient satisfaction were investigated.

Results

Postoperative complications included skin necrosis (2.4%, n = 4) and muscle flap necrosis (0.6%, n = 1), but no severe complications were observed. After a mean follow-up of 58.6 months, eight patients (4.8%) experienced local recurrence. Sixty-month distant metastasis-free survival rates for Tis, T1, and T2 were 100%, 97%, and 83.3%, respectively, with an overall rate of 88.4%. Furthermore, overall survival rates for Tis, T1, and T2 were 100%, 94.1%, and 94.4%, respectively, with an overall survival rate of 95% for all patients. A patient satisfaction survey showed that 81.6% of patients evaluated the surgery as “good.”

Conclusions

VA-SSPM for early-stage breast cancer improves cosmetic results and achieves high patient satisfaction without increasing local or distant organ recurrence. This method offers a useful local therapy for early-stage breast cancer.

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Title: Clinical Outcomes of Video-Assisted Skin-Sparing Partial Mastectomy for Breast Cancer and Immediate Reconstruction with Latissimus Dorsi Muscle Flap as Breast-Conserving Therapy
Authors: Hiroo Nakajima
Ikuya Fujiwara
Naruhiko Mizuta
Koichi Sakaguchi
Mahiro Ohashi
Asako Nishiyama
Yoshimi Umeda
Miho Ichida
Junji Magae
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 9/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0607-0

At a glance: The STEP trials

Springer Medicine

Clinical Outcomes of Video-Assisted Skin-Sparing Partial Mastectomy for Breast Cancer and Immediate Reconstruction with Latissimus Dorsi Muscle Flap as Breast-Conserving Therapy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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